Articles on adoption, foster care, & pediatrics

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Strengths & Difficulties Questionnaire

The Strengths and Difficulties Questionnaire (SDQ) is a well-done, brief (5 minutes), validated behavioral screening tool for 3-16 year olds that compares well to longer tools like the Child Behavior Checklist (CBCL/Achenbach). It can be completed and self-scored by parents, teachers, or adolescents themselves.

All versions of the SDQ ask about 25 attributes, some positive and others negative, in the domains of emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, and prosocial behavior. Questions also assess the impact of these problems at home, school, and with peers. Follow-up versions of the SDQ are available as well.

Even better, a free online version for parents of 4-16yo children can generate scores and interpretations for us, with linkage to book or website ideas, and some statistics on how likely a professional would be to find a "diagnosis" in a child with similar scores. The report comes in a "readable version", which has a neat "stressometer" graphic, likelihood of a diagnosis (appropriately, it does not actually diagnose your child), and overall impressions, with links to targeted book and websites. You can also view and print out a "technical version" with scoring to bring in to your providers, which can be very helpful at visits.

According to the authors:

"The information provided by parents is used to predict how likely a child is to have emotional, behavioral or concentration problems severe enough to warrant a diagnosis according to the ICD-10 or DSM-IV classifications. For each diagnostic grouping, there are three possible predictions: ‘low risk', ‘medium risk' and ‘high risk'. In general, these predictions agree fairly well with what an expert would say after a detailed assessment of the child. Around 25-60% of children who are rated as ‘high risk' do turn out to have the relevant diagnosis according to experts. So do around 10-15% of ‘medium risk' children but only about 1-4% of ‘low risk' children."

The authors have a nice page on "why bother with diagnoses". As for me, I'm a fan of picking up emotional/behavioral/attentional/social concerns promptly, and hope that parents and teachers of my patients will take advantage of this free and easy screening tool.

Like any screening tool relying on parent/teacher report it can be skewed by overly rosy, or more typically, overly negative feelings about a child. If you're seeing red, your child will score in the red - step away from the questionnaire ...

Also, a five-minute questionnaire is certainly not a substitute for professional evaluation, but can help you decide whether or not you might need to seek that help. Please bring your concerns and reports to us so that we can discuss what's going on and make appropriate interventions or referrals.